LSD (Lysergic Acid Diethylamide) Guide

A number of drugs have been discovered by accident. One of the most famous cases of accidental discovery of a compound is the discovery of the hallucinogenic drug LSD (lysergic acid diethylamide). The drug was one of many compounds developed from the parasitic fungus ergot in the 1930s to assist in the process of childbirth. Its original name was LSD-25, as it was the 25th compound in a series of drugs that were developed from ergot. The drug was originally found to have no use for helping with childbirth and was ignored for several years.

One of the chemists involved in the development of these compounds, Albert Hoffman, decided to go back some years later to determine if any of them had any medical uses. He somehow ingested some of the LSD-25 and began to experience vivid visual perceptions and hallucinations as well as mild euphoria. Further experiments with the drug led to it being proposed as a potential drug to treat certain psychiatry patients.

The hallucinogenic properties of the drug made it quite popular outside medicine. LSD was a significant part of the drug counterculture movement in the 1960s. As the movement began to fade, LSD also declined in popularity.

The United States Drug Enforcement Administration (DEA) went on to classify the drug as a Schedule I controlled substance. This DEA classification is reserved for drugs that are believed to have no medicinal purposes and are extremely dangerous in terms of their ability to produce physical dependence and to be abused. Despite this classification, there are a number of sources that believe LSD still has medicinal uses, particularly in the treatment of certain types of issues, such as issues with anxiety or trauma- or stressor-related disorders. Nonetheless, at the time of this writing, there are no FDA-approved uses for LSD.

Primarily a Hallucinogen

LSD remains classified as a hallucinogenic drug by the DEA and is listed as such by most major organizations, such as the National Institute on Drug Abuse (NIDA). Hallucinogenic drugs or hallucinogens affect an individual’s perceptions, such that the perceptions are significantly distorted from reality.

Some drugs, like cannabis, produce alterations of perceptual experiences, and most drugs of abuse alter an individual’s perceptions of their sensory input but not in the radical way that hallucinogens do. Hallucinogens alter individual’s perceptions such that they are often experiencing events that they believe are happening in their environment that really are not there, such as seeing or hearing things that are not there, thinking they can hear colors or see sounds, feeling as if they are becoming detached from their body, or feeling as if their environment is not real. Other hallucinogenic drugs include mescaline, psilocybin (magic mushrooms), and PCP.

How LSD Is Used

LSD is also interesting compared to most other drugs in that it produces very powerful and long-lasting effects in extremely small doses. NIDA reports that the average dose that users of LSD ingest is between 100 and 200 micrograms, which is an extremely small amount of the pure drug (smaller than a grain of sand).

The drug is primarily taken orally as tablets or powder, or in a liquid form that is often placed on some type of ingestible paper. Despite the average dose being extremely small, the effects of the drug are very long-lasting, and in many cases, the effects last 10-12 hours or even more.

Intensification of sensory experiences: This intensification is most often experienced as seeing colors more brightly and clearly, sounds being heard as much more acute, a more sensitive sense of touch, etc.

Changes in mood: For most people, these are generally feelings of wellbeing and contentment; however, some of these changes do appear to be dependent on the specific environment or context in which the drug is taken. For example, some individuals who do not know what to expect when taking the drug may become anxious and feel that they are losing control, and this may spur panic attacks or other negative experiences. Other individuals who take the drug together with the purpose of experiencing expected pleasant psychoactive effects do not often have these types of experiences. Other individuals may feel enhancements of their emotional states, such as increased depression, grief, etc. Sometimes, negative experiences associated with use of LSD or other hallucinogenic drugs are referred to as “bad trips.”

Hallucinations: Visual hallucinations, or seeing things that are not really there, are the most common hallucinations; however, individuals can also hear, smell, or even feel things that are not there.

Various other changes: These other changes will vary from person to person and may include alterations in body temperature, impaired motor coordination, irregular or accelerated heartbeat, dizziness, nausea and vomiting, and headaches.

LSD Overdose

Research looking at individuals who have taken extremely high doses of LSD generally finds that these individuals recover. There appears to be no reliable case on record where an individual suffered a fatal overdose from LSD alone. There are reported cases of fatal overdoses on hallucinogenic drugs that are similar to LSD. The majority of the research that has documented cases of fatal overdoses where LSD was involved also noted that the individuals had taken other potentially dangerous drugs, such as alcohol, narcotic pain medications, etc., along with LSD. However, because LSD produces effects at very small doses, it is certainly conceivable that individuals could ingest a fatal overdose of the drug, although this would have to be an extremely high dose.

Most of the information regarding the symptoms of LSD overdose comes from case studies where individuals took significantly higher doses of LSD than are normally taken. The majority of symptoms that occur in these individuals were:

Fever

Nausea, vomiting, and, in some cases, gastric bleeding

Issues with respiration, in some cases

Potentially comatose state

It appears that these documented cases of LSD overdose were treated successfully, and none of these individuals had any significant ill effects following their recovery. However, it is important to note that using hallucinogenic drugs does have potential dangers. As mentioned above, individuals are prone to poor judgment while under the influence of these drugs, and there are a number of cases in the media where individuals have been involved in accidents while under the influence of these drugs. The formal diagnosis for individuals who have used hallucinogenic drugs like LSD and lost contact with reality to the point of being a danger to themselves or others is hallucinogen-induced psychosis. This is a formal diagnosis given to individuals who are under the influence of a hallucinogenic drug like LSD and have lost control of their behaviors.

It has been popular in the media to link long-term use of hallucinogenic drugs like LSD with an increased potential to develop severe mental illness. Hallucinogen-induced psychosis is a temporary state that typically resolves once the individual’s system detoxifies itself from the drug. A large recent study found no significant link between the use of psychedelic drugs like LSD and the development of later mental illness or severe mental illness, such as psychotic behavior (e.g., schizophrenia). However, there are some rare potential long-term issues associated with LSD use.

Hallucinogen-Induced Persistent Perception Disorder

The American Psychiatric Association (APA) recognizes a formal mental health disorder associated with previous use of hallucinogenic drugs, particularly LSD. This disorder consists of an individual having flashbacks, or the types of experiences that they typically used to have when they used these drugs. The formal term for the disorder is hallucinogen persisting perception disorder (HPPD). These experiences can occur even though the person has not taken a hallucinogenic drug for quite some time. Most often, these experiences are not as intense as the actual intoxication of the hallucinogen. Commonly, individuals begin seeing halos around objects, perceive colors and sounds as being more acute than they really are, and may actually have some mild hallucinations.

It appears that this disorder is more common in individuals who have a history of some other mental health disorder and a history of bad trips, or individuals who have used other drugs, such as narcotic pain medications. The disorder also appears to be quite rare. APA estimates that only 4 percent of individuals who regularly used hallucinogens like LSD will develop it. Nonetheless, it can be stressful for individuals who do develop the disorder, and there is no cure. Typically, individuals with this disorder are given anticonvulsant drugs or other medications to manage the specific symptoms they are experiencing.

Hallucinogen Use Disorders

Hallucinogenic drug use is often associated with a rapid development of tolerance. This means that individuals that take these drugs on a regular basis will find that they need to use more of the drug to get the effect they once got at lower doses. However, most hallucinogenic drugs are not drugs that have a significant potential to cause physical dependence, according to APA and NIDA. Physical dependence consists of displaying both the symptoms of tolerance and withdrawal. There is currently no evidence to believe that chronic use of LSD can result in physical dependence. However, physical dependence on a drug is neither a necessary condition, nor is it a sufficient condition, to be diagnosed with a substance use disorder (substance abuse or addiction).

APA lists specific diagnostic criteria associated with hallucinogen use disorder, which would encompass chronic abuse of LSD that results in negative ramifications for the person.

Individuals who develop hallucinogen use disorders as a result of LSD abuse will often display multiple issues with control over their use of the drug that can include:

Frequently using more of the drug than the person had originally intended to use or frequently taking it for longer periods of time than originally intended

Frequently spending significant amounts of time trying to get LSD, using it, or recovering from its use

Often using LSD in situations where it is dangerous to do so

Continuing to use LSD even though its use is causing issues at work, in interpersonal relationships, with finances, at school, or other important areas of life

Giving up once valued activities in order to use LSD

Expressing a desire to stop using LSD or cut down use, but not doing so

A formal diagnosis of a hallucinogen use disorder can only be made by a licensed mental health clinician who evaluates the individual personally. People who use LSD as a means of coping with everyday stressors are likely to engage in the type of use and abuse that leads to the development of a formal substance use disorder. Even though there does not appear to be a formal withdrawal syndrome associated with chronic use of LSD, individuals who have hallucinogen use disorders as a result of LSD abuse may experience a number of psychological issues once they discontinue use, such irritability, anxiety, and depression.

Treatment

Interestingly, NIDA and APA suggest that a great number of people who use LSD typically stop using the drug on their own and without significant serious ramifications. Treatment for a hallucinogen use disorder would be warranted when an individual is having issues with controlling use that are leading to significant impairment or dysfunction in life. Because there does not appear to be a severe potential for withdrawal, most individuals being treated for LSD abuse would not need to be engaged in a physician-assisted withdrawal management program unless they are abusing other drugs, such as alcohol, narcotic pain medications, cocaine, etc., along with LSD.

The cornerstone approach for treating any substance use disorder is getting the individual involved in substance use disorder therapy. This therapy is administered by a trained, licensed, mental health clinician who uses psychological principles to assist the individual in understanding the reasons for their drug abuse, altering their behaviors, learning stress management, dealing with cravings, and developing a plan of relapse prevention. In addition, because many individuals who use LSD are typically younger, family involvement in the form of family therapy may be warranted.

Support from family, friends, and peers is extremely crucial in recovery. Regularly attending support groups such as 12-Step groups can be an added form of support for the individual, and these groups can continue to be of service to the person long after they have completed therapy. Twelve-Step groups allow the individual to interact with others in recovery, learn from them, share experiences, make lasting connections, and model the behaviors of those who are successful.